ECE2017 Guided Posters Pituitary & endocrine Tumours (12 abstracts)
Vertebral fractures are prevalent among patients with acromegaly in spite of normal bone mineral density reflecting overall duration of disease regardless of biochemical control or cure
Marko Stojanovic 1, , Dragana Miljic 1, , Sandra Pekic 1, , Mirjana Doknic 1, , Marina Nikolic Djurovic 1, , Zvezdana Jemuovic 1 , Vera Popovic 2 & Milan Petakov 1,
1Clinic for Endocrinology, Diabetes and Metabolic Diseases, Clinical Centre of Serbia, Belgrade, Serbia; 2University of Belgrade, School of Medicine, Belgrade, Serbia.
Introduction: Skeletal complications of acromegaly are among its most persistent and invalidating impacts. Dual-X-ray absorptiometry (DXA) alone might be insufficient or even misleading for bone health assessment in acromegaly.
Patients and methods: Patients with acromegaly (N=170) were classified as active (N=104), operatively cured (N=34) or medically controlled (N=32). 57 males and 113 females were included, 52.8 (22.0–78.5) years old. Bone mineral density (BMD) was assesed at L1-L4 and Femoral neck (FN) using DXA Hologic Discovery-W-QDR. BMD results were expressed as Z score, accounting for age and gender. Vertebral fracture assessment (VFA) on Th4-L4 was performed in 71 patients (24 male, 47 female) to identify number, type, location and degree of severity of vertebral fractures (VFs).
Results: L1-L4 BMD was normal in all patients and not significantly different in active (Zsc: 0.61±0.13) cured (Zsc: 0.32±0.25) or controlled acromegaly (Zsc: 0.17±0.32). FN BMD was normal in all and not significantly different in active (Zsc: 0.61±0.11) cured (Zsc: 0.59±0.19) or controlled acromegaly (Zsc: 0.49±0.22). VFs were identified in 23.9% (17/71) of patients. Prevalence in males was significantly higher than in females (33.3% vs. 19.2%; P<0.01). Patients with and without VFs did not differ in BMD L1-L4 Zsc (0.98±0.06 vs. 1.04±0.02) or FN Zsc (0.83±0.05 vs. 0.86±0.02). Duration of the disease in patients with VFs was significantly longer (14.1±1.9 vs. 9.6±1.2yrs) then in those without VFs (P<0.05). Prevalence of VFs was significantly higher in controlled (62.5%) and cured (40.0%) compared to active (17.8%) acromegaly (P<0.01).
Conclusion: Considerable prevalence of vertebral fractures (24%) was identified in a large cohort of patients with acromegaly, irrespective of normal bone mineral density. Duration of the disease was the main determinator of VFs prevalence, regardless of the biochemical control or cure. VFs are important, persistent and invalidating yet often under-recognized complication of acromegaly.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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